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Why I Skipped The National Day of Action on Refugee Health Care | By Kris Wayne

On Monday June 17th 2013, doctors, nurses, med students, and other interested and involved parties gathered across the country to protest against federal cuts to comprehensive refugee health care made back in June of 2012. Like all med students at the U of A, I was invited numerous times to attend and permission was even granted by the faculty to take the time off for travel and attendance for those of us not on summer break.

So why didn’t I go? Is it because I don’t believe that refugees should have comprehensive health care? No, that’s not it at all. In fact, I couldn’t possibly be more supportive on the issue. I didn’t go because it is my belief that this protest will harm the cause more than help it. This “day of action” is a travesty from the public’s perspective, and here is why:

On the whole we are a fairly caring country and Canadians value fairness and equality above much else. I would argue that that is why our universal health care system is considered to be one our greatest accomplishments, and why Tommy Douglas always ranks high on the list of the most beloved Canadians. This is exactly why many Canadians stand firmly with the government on this issue. The public perspective is that we are giving refugees, people who have never contributed to our country, a higher standard of health care than we give ourselves (so-called “gold-plated health care”). We collectively freak out when the high rollers (many who contribute hundreds of thousands of dollars to health related charities) go cue-jumping or get quicker access to medical imaging by paying for it out of pocket. So really, this is par for the course. Comment boards are flooded with statements like “my husband works two jobs so we can pay for our kids’ braces. Why do they come here and instantly get free dental?” and “I pay three hundred dollars out of pocket a month for my meds. Why do they get them free?” Now I’m not saying that these people have a complete grasp of the situation or that this is my opinion; I am only showing rightly or wrongly how many Canadians view the situation (the reason why is moot at this point).

So to the average Canadian it looks like the protesters are starting off with an argument that they think that refugees should have better health care than the taxpayers (including people like veterans, and our own homegrown poor and needy). To make matters worse, who are the people protesting? Doctors, DOCTORS! The literal 1% top earners in Canada. The people who “make all of the money playing god and who don’t really know what they are talking about anyway”. Those guys. This a public relations nightmare. As much as it pains me to admit, doctors are not the highly respected people they used to be; this isn’t the 1950’s. Many people trust what they have read on WebMD and Wikipedia over their family physician’s opinion when it comes to matters of their own health. They could care less about doctors’ policy concerns. From the outside this looks like a bunch of overpaid people who make their living on the backs of the working man turning around and then asking those same people to carry the burden of some rookie Canadians. No wonder every third comment I read is “if the doctors want them to have free dental let them pay for it”.

The term “refugee” has become synonymous with “false asylum seeker” when the reality couldn’t be further from the truth. Playing back to Canadians’ sense of fairness, we take a special dislike to people who don’t do things fairly and the news sites can always get a high rating story when they do an “in depth” look at refugee claimants in Canada or illegal workers. The truth is that there is a massive difference between a refugee and an immigrant. An immigrant is someone from another (at least semi-normal) country who decides to come live here and then applies and goes through the process. They could be from the US, England, China, Pakistan… etc., for a variety of different reasons like work, school, or family. A refugee is someone who comes from another country because they are allergic to being killed, tortured, or discriminated against. Canada has a list of countries considered special status and a few different ways that people can be sponsored to come here as a refugee. Only one of these methods is through claiming asylum once on our soil. The problem is that most Canadians aren’t aware of this. Why would they be unless they have been through it or work for an agency?

The reality of the problem is sobering. Refugees are, for the most case, people that we have sponsored to come and live in Canada to protect them from war and civil strife in their home nations. They are for all intents and purposes invited guests, not party crashers. What we are doing to them is tantamount to inviting them to our house for dinner and then telling them once they are here that they need to bring their own food (except they can’t afford it and that’s why we invited them in the first place). That being said it is easy to see why the government is getting a free pass by the public on this egregious error. It is all about optics, perspective, and that is not something being taken into account by the well-meaning people who went to the rally today. The obvious counterpoint is that the intent of the protest is to increase public awareness but that is not what I see happening. The media isn’t at the rally to function as an educational tool for the public on the arguments the doctors are making; they are there to report on the protest, and they will do so as they always do, in the manner that allows them to get the most out of the story for their own sake.

In an alternate ideal world here is the story of how an alternate protest would have gone down if I was king of the universe:

Doctors and health care workers gathered across the country today to protest inefficiencies in health care spending brought about by changes to federal spending on refugee care. Doctor Handsome Face was quoted as saying “because of these changes, the federal government is costing the taxpayers millions in emergency care with the potential that the number could be in the hundreds of millions of dollars after lawsuits brought on by the refugees are settled in the courts years from now”. It would appear that the government is liable when they accept responsibility as a host nation for the wellbeing of these people, many who are too poor to afford even the basic necessities. In the meantime doctors and dentists from across the province have pledged to provide for basic care out of their own pocket and association funds.

I’m no PR expert but I know that you have to work within the current public opinion if you want to change it and get anything done. Otherwise you could be simply wasting your own time while alienating the very people you are trying to enlist support from. I sincerely hope that we find our way to a solution on this issue. I hope that I am wrong and that these protests turn out to be effective. We as Canadians have a duty to these people, just as we do to ourselves, to look after each other. Anything else is to tarnish the ideal that so many Canadians hold so dear, that of health care for all.

Related

Kris, I’ve read and re-read your article with great interest, although I am still not sure I have a full grasp of your arguments. I am one of those “well-meaning people” that attended the Day of Action for Refugee Health here in Edmonton. I agree with you that there is a lot of misinformation about the Interim Federal Health Program (IFHP) that provides health coverage to our refugees. This misinformation should be even more of an impetus for physicians to raise their voices, not an excuse for complacency .

I am a local emergency medicine resident, and, as a frontline provider, I have an obligation to speak out on behalf of my refugee patients. Am I always the best spokesperson? Maybe not – but I refuse to bear silent witness as my government closes the door on some of the most vulnerable people in our country. Our refugees are suffering because of the changes to the IFHP. They are being denied access to potentially life saving investigations, assessments and therapies on a daily basis.

This is a very real and urgent issue. Unfortunately for all of us, our refugees cannot afford to wait for an “alternate ideal world” where you are the “king of the universe”. We need to act now. And while I may not be “doctor handsome face”, I do the best that I can. And I invite you to do the same.

Kris – if you want to meet with me to discuss this further please let me know. I would love for you to have the chance to meet with the local network of doctors, nurses, and community leaders involved in this issue before you continue to portray us as nothing more than a bunch of naive idealists.

Sandy Dong

Kris, I’m afraid I don’t follow your logic. While I agree that misinformation is rampant, silence is not the answer. As a future physician, one of your roles is to be an advocate for those who have no voice. Correct the misinformation, provide facts, fight ignorance. Use your blog and speak out.

Kris Wayne

I couldn’t agree with you more DR Dong, my point is that this is a fire and I would prefer to call for help rather than to throw gas on top.

Ben Toh

I’d suggest reading your code of ethics (see CMA code of ethics – I’d post the link but when I first posted this a day ago, the moderator rejected it because of the link)

“This Code has been prepared by the Canadian Medical Association as an ethical guide for Canadian physicians, including residents, and medical students. Its focus is the core activities of medicine – such as health promotion, advocacy, disease prevention, diagnosis, treatment, rehabilitation, palliation, education and research.” – Note the role of advocay

and Fundamental Responsibility #4 “Consider the well-being of society in matters affecting health”

and the section on Responsibility to Society, e.g. #42: “Recognize the profession’s responsibility to society in matters relating to public health, health education, environmental protection, legislation affecting the health or well-being of the community and the need for testimony at judicial proceedings.” and #43 “Recognize the responsibility of physicians to promote equitable access to health care resources.”

Kris Wayne

Thank you for your comment. I’m all for advocating for refugee health care, I whole heatedly support the cause. My point is that this form of advocating was not as productive as intended and had a negative affect on the cause. To be 100% clear, advocating yes, good cause, needs more attention, this form of protest bad, not effective.